Mama Jo's Inc. v. Sparta Insurance Company

CourtCourt of Appeals for the Eleventh Circuit
DecidedAugust 18, 2020
Docket18-12887
StatusUnpublished

This text of Mama Jo's Inc. v. Sparta Insurance Company (Mama Jo's Inc. v. Sparta Insurance Company) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eleventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Mama Jo's Inc. v. Sparta Insurance Company, (11th Cir. 2020).

Opinion

Case: 18-12887 Date Filed: 08/18/2020 Page: 1 of 24

[DO NOT PUBLISH]

IN THE UNITED STATES COURT OF APPEALS

FOR THE ELEVENTH CIRCUIT ________________________

No. 18-12887 ________________________

D.C. Docket No. 1:17-cv-23362-KMM

MAMA JO’S INC., d.b.a. Berries,

Plaintiff - Appellant,

versus

SPARTA INSURANCE COMPANY,

Defendant - Appellee.

________________________

Appeal from the United States District Court for the Southern District of Florida ________________________

(August 18, 2020)

Before NEWSOM, TJOFLAT, Circuit Judges, and PROCTOR,* District Judge.

* Honorable R. David Proctor, United States District Judge for the Northern District of Alabama, sitting by designation. Case: 18-12887 Date Filed: 08/18/2020 Page: 2 of 24

PROCTOR, District Judge:

In this insurance coverage case, we are called upon to assess whether the

district court properly excluded the opinions of Plaintiff’s experts and granted

Defendant’s motion for summary judgment based upon the conclusion that

Plaintiff failed to establish that it suffered a direct physical loss that would trigger

coverage. We conclude the district court correctly ruled on both questions.

Therefore, for the reasons more fully discussed below, we affirm.

I. Background

Appellant Mama Jo’s Inc. d/b/a Berries (“Berries”) owns and operates a

restaurant located at 2884 SW 27th Avenue, Miami, FL 33133. (Doc. 107-1 at 8-9).

The restaurant is located less than one mile from the ocean (Doc. 111-5 at 4; Doc.

111-6 at 57-58, 104), and is partially enclosed by a retractable awning, wall, and

roof system. (Doc. 109-4 at 4, 31; Doc. 109-5 at 66-68, 75-81; Doc. 110-8 at 104).

When the system is opened, the restaurant’s interior areas are exposed to the

elements. (Id.). The restaurant’s front entrance, bar, and seating areas are adjacent

to SW 27th Avenue. (Doc. 107-1 at 95-97; Doc. 109-5 at 51-54, 66-71, 80; Doc.

116-8 at 4-5).

A. The Road Construction

From December 2013 until June 2015, there was roadway construction at

different locations along SW 27th Avenue in the general vicinity of the restaurant.

2 Case: 18-12887 Date Filed: 08/18/2020 Page: 3 of 24

(Doc. 102 at 2; Doc. 107-1 at 58-60; Doc. 116-5 at 11). During that time, dust and

debris generated by the construction migrated into the restaurant. (Doc. 116 at 3-5;

Doc. 110-3 at 51-55; Doc. 110-8 at 54; Doc. 116-8 at 3-7; Doc. 116-9 at 3-15, 19-

29). Berries performed daily cleaning using its normal cleaning methods,

employing dust pans, hoses, rags, towels, and blowers. (Id.).

Berries was open every day throughout the time period of the roadwork.

(Doc. 116 at 3-5; Doc. 110-8 at 56-57, 95-97; Doc. 116-8 at 7-10; Doc. 116-9 at

25). Although the restaurant maintained the ability to serve the same number of

customers as it had before the construction began, customer traffic decreased

during the roadwork. (Doc. 116 at 3-5; Doc. 107-1 at 73-74; Doc. 110-8 at 56-57;

Doc. 116-8 at 9-12; Doc. 116-9 at 24-27).

B. The Insurance Policy

From September 19, 2013 to September 19, 2014, Berries was insured by

Appellee, Sparta Insurance Company (“Sparta”). (Doc. 110-1 at 5, 31-54). Sparta

issued an “all risk” commercial property insurance policy, which included, in

relevant part, a Building and Personal Property Coverage Form and a Business

Income (and Extra Expense) Coverage Form. (Doc. 110-1 at 31-54).

The Building and Personal Property Coverage Form contained in the policy

covers “direct physical loss of or damage to Covered Property . . . caused by or

resulting from any Covered Cause of Loss.” (Id. at 31). The policy defines

3 Case: 18-12887 Date Filed: 08/18/2020 Page: 4 of 24

“Covered Causes of Loss” as “Risks of Direct Physical Loss unless the loss is”

excluded or limited. (Id. at 33, 63).

The policy’s Business Income (and Extra Expense) Coverage Form provides

that Sparta will pay for “the actual loss of Business Income you sustain due to the

necessary ‘suspension’ of your ‘operations’ during the ‘period of restoration.’” (Id.

at 46). The policy provides that the “‘suspension’ must be caused by direct

physical loss of or damage to” covered property. (Id.).

C. The Initial Insurance Claim

On December 12, 2014, Berries submitted a claim to Sparta under the

policy. (Doc. 143 at 4). Berries asserted that the claim was related to dust and

debris generated by the roadway construction. (Id.). Sparta assigned Corey Buford,

an insurance adjuster, to review the claim on behalf of Sparta. (Doc. 116-10 at 5).

Berries hired a public adjuster, Robert Inguanzo of Epic Group Public Adjusters, to

assist with its claim. (Doc. 110 at 3).

In December 2014 and January 2015, Buford requested information about

the claim from Berries. (Doc. 116-10 at 6-8, 17-19). In January 2015, Inguanzo

responded to these requests and informed Buford that the claimed loss “occurred as

early as December of 2013 in the form of construction debris and dust from the

[roadwork]” and that, “the construction related debris and dust . . . caused damage

4 Case: 18-12887 Date Filed: 08/18/2020 Page: 5 of 24

to the insured’s building. The scope of loss includes but is not limited to, cleaning

of the floors, walls, tables, chairs and countertops.” (Id. at 17).

In March 2015, Inguanzo provided Berries with an estimate in the amount of

$16,275.58 to clean and paint the restaurant. (Doc. 110-10 at 1-10; Doc. 116-11 at

11-15, 23-25; Doc. 116-12 at 5-6). Inguanzo testified that, “based on our

inspection back then” the estimate encompassed “the work that we felt was

necessary to bring the property to its pre-loss condition includ[ing] the cleaning

and painting,” and that, “[a]t that time, we didn’t have anything for removal or

replacement . . . .” (Doc. 116-11 at 14-15).

In April 2015, Inguanzo sent Buford a “Sworn Statement in Proof of Loss”

for the building claim, including a preliminary damage estimate in the amount of

$13,775.58. (Doc. 116-10 at 21). This amount was calculated based on the amount

of the estimate -- $16,235.58 -- minus a deductible. (Id.). Inguanzo also sent

Buford a “Sworn Statement in Proof of Loss” and supporting documentation

regarding a business income claim in the amount of $292,550.84. (Id.). Berries

contended that its 2014 sales were lower than expected when compared to its rate

of sales growth in previous years. (Doc. 109-2).

On January 30, 2017, Sparta denied the claim because it was “not covered

under the [] policy.” (Doc. 110-13). As Sparta explained: “[w]ith regard to

Building coverage, . . . the Proof of Loss Form does not reflect the existence of

5 Case: 18-12887 Date Filed: 08/18/2020 Page: 6 of 24

any physical damage. It is also questionable whether a direct physical loss

occurred.” (Doc. 110-13 at 5). Sparta also stated that:

Under the Business Income Coverage Form, coverage is provided for the actual loss of business income the insured sustains due to the necessary “suspension” of “operations” during the “period of restoration.” The “suspension” must be caused by direct physical loss of or damage to property at the premises . . . .

(Doc. 110-13 at 6) (emphasis in original).

D. The Litigation and Presentation of a New Claim for Damages

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